Utility of Routine Exercise Stress Testing among Intermediate Risk Chest Pain Patients Attending an Emergency Department

National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Management of Acute Coronary Syndromes 2016

“…Increasingly, the utility of such testing is questioned in patients at low risk for an evolving ACS as defined by Suspected ACS-APs, which includes those with atypical symptoms, no or very few vascular risk factors, no arrhythmias or clinical features suggestive of arrhythmia and no prior heart disease. Evidence suggests that such patients are at negligible risk of MACE and further testing is not warranted [94][95][96] and may actually be harmful.…”

“…The criteria used to define low-risk patients in whom further investigation may not be warranted has varied in studies, and criteria we have defined may be contested [94][95][96]. If clinical suspicion is high (e.g.…”

452 Brain Injuries in Children With Congenital Heart Disease: A Systematic Review and Meta-Analysis

“…[1]. 10-20% of ESTs result in further testing [2][3][4] causing resource consumption with limited data regarding predictors of negative downstream testing [5].…”

Improved Assessment of Chest pain Trial (IMPACT): assessing patients with possible acute coronary syndromes

“…The value of this objective testing for most patients has not been established. 10,11 In this article, we describe the Improved Assessment of Chest pain Trial (IMPACT) protocol. This accelerated risk stratification protocol is an alternative to the 2016 NHFA/CSANZ guidelines for patients who present to the ED with a suspected ACS.…”

“…International guidelines recommend objective testing to exclude coronary ischaemia, 2 , 8 , 9 and most patients undergo additional investigation for coronary artery disease. The value of this objective testing for most patients has not been established 10 , 11 …”